PRESIDENT ASPIE?

First: Thank you from the bottom of my heart for being patient with me during my extended break from writing. As many now know, I am a nurse in the United States Navy and spent the last three years working a demanding schedule on the island of Guam. Since I never imagined my blog would reach the number of people it did, I was ill-prepared to keep up with my posts the way I should have (to not leave you all hanging).

I am settled in to my new location and have finally come to a place where my free time is truly my free time… which means I can begin writing again!

Thank you all for your patience and for holding on to hope that I had not vanished because my marriage failed (as some suggested). I was just taking a mental health pause to ensure my home/career foundation was solid before I dug back in to share the insanity and wonderment of my Aspie/NT-e marriage with all of you!

John and I are still going strong and I am still veryin love with my Aspie husband. I am still 100% optimistic and motivated to share every bit of positive insight I can with those who care to read. Our world is not now, nor will it ever be, sunshine and roses… we struggle in the same ways neurotypical couples do and we struggle daily to maintain and extend our bridge of communication. While our NT-e/Aspie union is unique to couples like us, we are also unique in the sense that we are both committed to the personal changes required to live a happy life with one another. Some days are awesome and some days suck royally! I will share it all with you… so get ready for some extended reading because I have a ton of posts that just need a bit of editing before they get put up!

I continue to be humbled by your support, your willingness to share your own deeply personal struggles and successes, and your desire to learn everything you can to understand your spouse, self, and our society better!

I have to address the elephant in the living room first…

While I anticipate some rapid-fire posts in the next few months, I have got to address a pressing topic that is refusing to vacate my mind (until I publicly acknowledge it with all of you). The elephant I speak of is our new president and the fact that the whole stinkin’ nation is suffering from a mental-chaos we NT-e wives know all too well!

Has the world gone mad?

Nope… they’re just experiencing the Cassandra Phenomenon!

A while back I put this post up suggesting that President Trump had undiagnosed Asperger’s syndrome. Being an active service member, I felt exceedingly uncomfortable writing about my Commander in Chief in a manner by which others could misinterpret as negative. Since this presidency has caused such an emotional response, I felt intimidated that my words could be twisted, or that some might misunderstand my motives for writing about Mr. Trump. Being that I respect those appointed over me with the highest regard, I was fearful that I could be overstepping my professional obligation to my Chain of Command by sharing my personal beliefs, so I took the post down.

For nearly five months, I waged an unnecessary battle in my mind over this topic imagining the worst possible responses and repercussions for sharing my thoughts. The longer I delayed my desire to point out the obvious, the more frustrated I became with the hysterical rhetoric all around me. As mentioned, I am not a politically outspoken individual and I never have been. I have a professional obligation to never allow personal views to conflict with my military duties and the oath I swore to live by; for this reason, I have always exercised great caution in putting my political opinions out on display. Being that I am also highly opinionated and inherently outspoken in every other aspect of my waking days… I historically found great success in limiting my exposure to the propaganda and “news” found on social media and other outlets. This tactic worked flawlessly for nearly 15 years of military service…

This tactic is impossible to implement now that the whole nation has lost their damn mind!

From day #1 of the presidential campaign, I have looked at Mr. Trump and thought… “Well he is obviously an undiagnosed Aspie!”

As time progressed, I found it really odd that no one else was talking about this seemingly obvious rationale for why he says some of the “inappropriate” things he does. I could not wrap my head around why no one was identifying why he appeared so focused on trivial things to the exclusion of things deemed socially important. Why didn’t everyone else realize that he was chronically lobbying for social acceptance even though his behaviors and words were having an opposing (alienating) outcome… an outcome he always seemed dumbfounded to come upon. It was beyond apparent to me why Mr. Trump continuously acted out in a defiant and aggressive manner the moment he suspected his character was under attack and it was remarkably familiar to watch him preemptively lash out in defense the moment he perceived a potential threat on the horizon. It was also (almost) comical to me that he was in the running with my husband for the world’s WORST “liar.”

I could not comprehend why people kept referring to him as a sociopath when I was watching a man who clearly did not notice how and why his words were continuously being perceived as malicious and negative. Every time I heard him contradict himself or repeat the same points ad nauseam without picking up on the shit-storm they elicited from the press… I just thought to myself; “Well, duh! That’s what happens when you are blind to cognitive empathy!” All of the unnatural facial expressions, the off-beat tone and pitch by which he spoke, the juvenile-seeming words he chose, the missteps in body language cues, the filter-less verbalization of internal dialog, and every other social faux pas he exhibited… all made for easy box-checking under the list of undiagnosed adult male Aspie behaviors… but no one else appeared to be privy to the same list of common sense explanations I was. The more time progressed, the clearer the explanation became in my mind. The clearer it became for myself, the more distorted it was becoming for those around me until eventually the general consensus was that our 45th president was a narcissistic sociopath hell-bent on destroying the country!

Wait… what?!?!?

The saddest part of this entirely paranoid (and incorrect) conclusion about President Trump was that it was promulgated by the very people who should have been educating the masses on the exact opposite. I watched countless mental health professionals diagnose Mr. Trump (on air) with personality disorders and miss the very obvious diagnosis he unquestionably warrants (in my mind).

The most ironic part of this hostile character assassination of the president is that the people demonstratively shouting that he lacks empathy are the very members of society who claim to be the most empathetic! While I do not agree with the financially motivated bullshit diagnosis of Autism Spectrum Disorder (I will refrain from going off on this rant), society has accepted this spectrum to include those with Asperger’s syndrome. In a disturbing twist of justice and acceptance, the masses (who passionately hate President Trump) are too blinded by their own self-righteousness to see they are literally “shaming” and bullying a member of our society who, by current diagnostic criteria, has AUTISM!

If that is not irony, I don’t know what is!

I keep wondering what would happen if President Trump received an official diagnosis of ASD. Would those that hate him suddenly shift and regret their incessant attempts to bash him as a human? In my heart, I know they would never accept such a simple explanation because it does not fit in with the narrative that has been created and it most definitely does not fit in with the misunderstandings society has about Asperger’s syndrome (or ASD) in general!

The Defiant Aspie Husband

Struggling to see my perspective on this topic?

Not all adult men with undiagnosed Aspergers are defiant or aggressive in nature. I think at this point, most of the readers who spend time on this website are either Aspies themselves (accused of behaving this way), or NT-e’s who are struggling to function in a relationship with a spouse who comes across as such. As stereotypes go, the more docile and meek an adult Aspie (undiagnosed), the less likely they are to marry an emotionally-charged NT-e. So… for the sake of my readers who predominantly fall into the above mentioned dynamic… I have some pressing questions for you. If you are having trouble considering my conclusions about a man who has inadvertently created mass hysteria in our country, let me ask you this:

What would happen if you took your defiant Aspie husband and allowed him to be raised with financial power and privilege? What if your husband grew up in a world that did not make sense to him, felt alienated by society overall, could not understand why his best efforts still left people criticizing his character and assigning fault and malicious intention where he innocently never intended it to exist? What if you gave your husband great wealth and surrounded him with people who were too intimidated by his “power” that they never put him in check, rarely disagreed with him, appeased his socially-unacceptable behaviors, or (worse), praised him for being successful without any degree of critique for how he acted in the process of obtaining each success? What if he learned (like my husband did), that the louder, blunter, or more aggressive he became with those he did not understand… the faster he could silence their disapproval or make their incomprehensible and confusing emotional dialog disappear?

What would you be left with if your husband had been raised in that kind of environment?

Would he look a little like President Trump?

I know I cannot make sense of this to the general public… but I have a sneaking suspicion that those NT-e wives out their who reside with a defiant Aspie husband; those who know the devastation of experiencing the Cassandra Phenomenon first hand… I believe you may be able to see the same thing I am. I also believe that if you really stop to consider why the media and society has responded to President Trump the way they have, you will quickly realize they are enduring the Cassandra Phenomenon themselves! How’s that for a bizarre twist in the Aspie/NT-e dynamic no one else could ever comprehend?

To those who still find my simple explanation for our President’s demeanor too forgiving and cannot let go of the idea that he is a narcissistic sociopath:

Do you really think Mr. Trump is a skilled manipulator? Sociopaths are. Remember, those with Antisocial Personality Disorder have exceptional cognitive empathy (but zero emotional/affective empathy). These people are tuned in to how a person is feeling based on the non-verbal dialog taking place (they just don’t care). It is this intuitive ability to read nonverbal language that enables those with APD to manipulate a person and play on their emotions and empathy to get what they want out of them.

Does the president appear to be playing a game of chess with the public, appeasing to their empathetic nature in a manipulative manner? Or, does the president appear to be shooting from the hip every time he opens his mouth or posts another tweet that seems to be anything BUT well-thought out?

Does the president appear to be a socially-skilled and articulate man who commands attention and a desire to please? Or, does he appear to be so socially awkward he misses the simplest cue to shake someone’s hand appropriately or even follow the basic rhythm of socially acceptable dialog?

Does the president seem to take pleasure in the pain his behavior causes? Or, does he seem completely oblivious that he bears any responsibility in causing anyone else’s personal distress? Does he respond in a cold manner towards humanity by carrying out cruel acts? Or, does he spout off seemingly callous words and then lack the follow through once he identifies the actual human repercussion his suggested actions might pose on real people?

If you’re tracking right now, you may be noticing that this narcissistic sociopath is anything but a smooth manipulator and a whole lot closer to a man who is blind to cognitive empathy but also lacks the boundaries those like him have in their immediate environment.

Are you considering that maybe he does have emotional empathy but lacks the ability to implement it… simply because he is chronically missing the cognitive empathy/nonverbal messages required for a person to identify when a situation calls for it?

Look at our First Lady. Look at Mr. Trumps family. Do you really believe this man is an evil narcissist, or do you think maybe his friends and family know a side of him that we are not seeing, a side that elicits the words they have shared to defend him as a good man?

Please tell me I am not THE ONLY PERSON who VERY CLEARLY sees that our new Commander in Chief is an Aspie?!?!?

Just because I think President Trump is an undiagnosed Aspie does not mean I automatically like, approve of, agree with, or want to defend him as a person (nor am I denying that I do). There are no cookie-cutter individuals with Asperger’s syndrome, just as there are not definitive criteria for deeming someone a neurotypical. There are phenomenal Aspies out there and there are real crappy ones.

While no two people are alike, there are defining characteristics that are overwhelmingly present for those with Asperger’s syndrome; particularly adult men who have never been diagnosed. From my perspective, President Trump possesses all of these defining characteristics. These characteristics have been and continue to be so apparent to me that I am chronically disappointed no one else is pointing them out in lieu of demonizing him each day. In a sad way, I see constant similarities between my husband and Mr. Trump. I find this sad because I feel empathy for him each time he seems to miss social-norms and I listen to the cruel backlash the media spews at him without missing a beat. The more immature and mean-spirited the media becomes, the more I think about my husband and other adult men with undiagnosed/diagnosed Aspergers and how unfairly judged they have been throughout their lives. I think about how I know what a good man my husband is despite being able to see how others miss this truth when he behaves in socially inappropriate ways or says things without considering how others might perceive his words.

Yes, it does sadden me to think about how cruel our society is towards President Trump and while I can also understand how his behavior often triggers such responses… I am disappointed in how quickly the masses jump on the negative bandwagon and launch attacks on his character without pausing to consider any other perspective. Sometimes I see Mr. Trump come under attack for innocent missteps (and I will submit that not all are)… but when I put those behaviors in the context of an individual living with the struggle of AS, my heart breaks a little for his/their pain.

If I am correct about President Trump having undiagnosed Asperger’s syndrome, then we are all witnessing the completely disgusting way that our Aspie partner has been treated in his life on a grand scale. Since I have held this belief from the start of Mr. Trump’s presidential campaign, I have grown tired of the mean-spirited way society has behaved and I am growing more offended each day that we reside with such ignorance… not just from the general public, but from the mental health professionals out there who should have picked up on this by now!

I just cannot make sense of the professional ignorance

How are the mental health professionals and Autism advocates missing this poignant representation of how ASD may present itself in an older adult and at least considering this to be true of President Trump?

Don’t these mental health professionals (deeming him a sociopath) even realize the degree of skill a true sociopath has to manipulate people? Since this man has proven to show success in business, he is educated and intelligent enough to prove if he were a sociopath… he would never say the random, blunt, and often inappropriate things he does. If he was so narcissistic… don’t you think he would be the last person vehemently arguing and defending his character against anyone who he perceives as a hostile threat to his sense of self? If he was not lacking cognitive empathy, wouldn’t he be able to tell how his own facial expressions, body language, and tone of voice was being perceived by those around him? If he had cognitive empathy, wouldn’t he prevent himself from coming across this way to others who oppose him so he could get the upper hand on the people he is “trying to control”?

All I see is an undiagnosed adult Aspie who is still preoccupied with wanting to prove he is a good man and bitterly and heart-brokenly devastated that some people question that… to the point that he acts out in a childish, hostile, and defensive attack mode against anyone he perceives as a threat. Doesn’t this sound familiar to any of the NT-e wives out there? I see insecurity and fear; I see a lack of comprehension for “why” people are unfairly judging him. I see an absence of comprehension for what words/comments/suggestions he lets out causing the backlash they do. I see a man who is accustomed to being criticized for things he does not understand to the point he no longer tries to apologize and has learned to just aggressively stand his ground regardless of how trivial an issue or simple it would be to try to make “nice” with others… because he never learned (or had to learn) how to accomplish this juvenile conflict-resolution skill.

Please tell me what you are seeing… for your opinion truly does matter to me.

I do not see a skilled manipulator and I do not see an evil man.

Now, I have mentioned before that both Putan and Hitler have been “unofficially” thought to have / have had Asperger’s syndrome by some leading experts in the field. Obviously, having Asperger’s alone would not negate the potential for having a comorbid (coexisting) personality defect and I certainly question if Hitler was just an evil sociopath undeserving of an Aspie title. With that being said, I do think there are so many men walking around among us with undiagnosed AS. If I am correct that there is a very large population of adults out there just like my husband or Mr. Trump… it stands to reason that many of his supporters also find it hard to grasp why so many are making a big deal out of things they are also not seeing in his behavior, right?

I watch his facial expressions and they remind me of how my own husband looks in the mirror and seems to be “practicing” how to make his facial expressions come across in a good way. Sometimes my husband says the most inappropriate things… sometimes he even makes racist comments or spews out seemingly insensitive things about women and other cultures or generalizes people into lumped categories. Whenever I give him a hard time about it, I become aware that he is either joking (and his words did not appear as such), or he is making blanket comments that popped into his head and then sharing them out loud before he has a moment to consider how they may be perceived. 99% of the time, my husband and I agree on political and social issues despite the initial appearance (via his blunt and offensive comments) and it takes a serious discussion to realize he doesn’t actually believe or think the silly things that spew out of his mouth unintentionally. Aspies don’t always comprehend the balance associated with making politically incorrect jokes and/or when they go a little too far because they fail to pick up on the nonverbal language that tells them they are making someone uncomfortable or offending them.

Sometimes I think about the inappropriate thoughts I have that are fleeting and not actually how I perceive individuals. I often think to myself, “Damn man, if the random thoughts I have were said out loud… people would hate me!”

People don’t generally hate me because I was raised with exceptionally keen cognitive empathy skills and have learned the art of tact.

But consider an Aspie who never learned this degree of tact, a person in the public eye who has been raised with enough privilege to say whatever is on his mind without the backlash a typical person might get (because they have wealth and power to prevent those from combating him openly). Consider if this man never learned to shut his mouth and think about the things he truly felt vice the random fleeting thoughts he had in his mind… before they came out as audible sounds.

Maybe Mr. Trump is not as scary as some might think. I mean… if every political leader just said what they were thinking without implementing tact and utilizing cognitive empathy…. I bet they would seem a WHOLE LOT WORSE than Mr. Trump does.

If every bad thought he has makes its way out of his mouth (and it unfortunately appears to a lot)… at least we know where he stands even with his innermost evil human thought processes. Again, we are human and we all possess such thought processes intermittently, we were just lucky in our youth and learned (via cognitive empathy), how to appropriately keep these things to ourselves. All of this easily explains why President Trump says stupid, rude, insensitive things and then goes back and denies saying them. Not because he didn’t say them… but because he didn’t think before he spoke and doesn’t “really” think those bad things. To him, they were just words and not what he actually “felt” or “believed” and without cognitive empathy… he would just assume that everyone else should have enough sense to know this about him.

Just like you and I might have an instinctual response to the bred-in racism/sexism/ageism/every-other-ism from time to time and then get upset with ourselves for thinking such things (because we don’t actually believe them in our core), the president appears to do this as well. The difference is… we have an internal dialog that tells us to not allow those thoughts to invade our beliefs about humans and we are able to internally work out why we would allow societal prejudices to invade our minds when we don’t actually believe in them. It is very apparent (to me) that President Trump… well… his internal dialog is broken because he grew up without cognitive empathy.

Now that the elephant is out and I have beat the horse to death…

I do hold out the right to not share my opinion of what an undiagnosed Aspie in such an important position means for our future as a nation… because such unfiltered words can instigate unnecessary hate and negativity…. (as if you haven’t already realized this).

I do hope our President will make rational and logical choices when push comes to shove and that he has the presidential insight we are not privy to. I do pray someone else recognizes he has a cognitive empathy deficit and is able to stand by his side to mitigate some of the things he says in the future to prevent unnecessary conflict that (I do believe) he wants to avoid as the President of our great nation.

It is a great nation still. Just because we are seeing the ugly side of ignorance (from whichever perspective you hold), does not mean this is hopeless or we should cease to consider alternate perspectives.

What if I am right?

What if this is our chance to be vocal and to be true advocates? What if the most prominent figure in our society has Asperger’s syndrome and we are the only ones to bring this to light? What if this is our opportunity to actually educate the world about a diagnosis so prevalent, yet so unacknowledged… to help people understand how it truly presents itself? What if we had the power to start shifting the way we judge people and better the lives of those with AS (and those who love them)?

Work with me on this guys… think about what I am saying. I cannot imagine that an NT-e wife married to an adult Aspie man is not seeing familiar behavior patterns that don’t at least cause you to pause and consider it. If President Trump is an Aspie, then we have an incredible opportunity to begin educating society on something the mental health professionals dropped the ball on long ago.

The real question should be:

“HOW ARE THEY THE SAME?”

I was drafting a response to a comment by an amazing woman named Hilary who had taken the time to offer her insight and share personal accounts in reply to some of the things I have written when it occurred to me that she was addressing common sentiments I have read time and time again. Ultimately, I decided that perhaps it would be better served to create a post addressing these comments in lieu of simply replying to her.

How and why do I think Aspergers and Autism should be separated at this time with our current comprehension of all-things-ASD? I am going to launch into some seriously obnoxious rants about neuroscience from my current level of comprehension to help answer why I am such a staunch advocate for this.

I apologize to anyone who is an actual neuroscientist for I will most certainly dumb-down and trivialize what you understand and possibly motivate you to provide more articulate education on the subject matter. You are welcome to do this (and I think you are badass and envy your level of intelligence and chosen profession) but there is a good chance the readers will be equipped with the same capacity to grasp something so complex that I am and your words will fly far over our heads!

First, (and most important) I need to give credit to Hilary who inspired this post by sharing what she wrote in reply to my (thus far) controversial opinions and unfiltered slaughtering of the DSM-5 diagnosis of Autism Spectrum Disorder:

“Having Asperger’s comes with sensory issues that are not going to respond to medication or therapy with a mental health professional. These sensory processing issues cause a lot of problems with perception and get in the way of functioning. Also the muscle memory often doesn’t work well with Asperger’s so things like hand writing just do not improve with time or practice the way it would for an NT. How is a mental health professional going to address things like this? We have had to make so many accommodations to daily life in our home to function well, because of that I am thankful that Asperger’s is lumped with Autism. I was in counseling for a long time, it did no good. Also, antidepressants had a terrible outcome. There are environmental changes which once they’re made, make it much easier to function normally, then the symptoms are decreased and the person can progress. Counseling could help provide coping techniques, but the sensory issues that are at the heart of Asperger’s need to be addressed. There are also so many physical medical conditions that contribute to or result from Asperger’s- both of my children wear glasses, have hearing issues, gastrointestinal issues, sleep problems, etc. that when we treat one of those, they are more able to function emotionally and socially. Psychiatry can’t touch those and they have a major impact on where they’re at on the spectrum.

I hear how upset you are and I’m sorry that this is so frustrating. I feel angry a lot too. I see your points, and they are valid. It’s quite possible that I don’t understand you fully, I don’t understand the technical aspects of this. All I know is that with getting help for my children, their medical and sensory issues have to be cleared up if we want to make lasting changes to the social/emotional parts. Just the sleep disturbances/breathing problems alone cause so many meltdowns during the day. Both are high functioning and you wouldn’t realize that they have so many medical issues, but they do. The blanket term Autism, helps us to look at these problems as part of the whole. Mental illness also goes hand in hand much of the time just because of how stressful growing up with Autism/Asperger’s is and how people treat you when you have it. It can start to overshadow the true problems, which if cleared up would help a lot.

One final thought- the DSM is based off of and changes with social norms. Being gay used to be in the DSM along with many other things that we no longer consider to be mental illness. I share your anger in the money that is being made off of the people who are suffering. A lot of money is made off of people believing that something is wrong with them. More understanding, love and patience would be a good thing all around. Our society makes me sad and I don’t put a lot of stock in these labels. People intrinsically know when they aren’t loved for who they are and it causes all sorts of odd behavior. Much can be avoided if we understand that we cannot change another person and instead meet them where they’re at and love them unconditionally.”

First, I absolutely appreciate her words and agree with the comment that we should accept one another as we are and love them unconditionally. I will disagree with the fact that I believe we should try to change some things about people. We can change, all of us, in various ways to become our very best selves in life and in relationships (not that she was suggesting against this). I want to change my husband’s negative behaviors and I am hell-bent on doing so, even if that means I am an unaccepting jerk to others.

Ok, so I am a self-proclaimed ADHD sufferer in need of some serious medication, so you may imagine what rabbit holes my brain took me down after reading her comment. After a lot of effort to ground myself (sort of) I was able to organize some degree of structure to address her words:

I wonder if those who can share these feelings (their spouse or children) were ever receiving counseling for an Aspergers or Autistic diagnosis by a professional who specialized in one of those “disorders” (I HATE that word!) before the DSM change grouping it all under ASD?

I would be interested to hear from those who could give examples of how the therapeutic benefit of the ASD focus provides better assistance then having the two treated separately. Unfortunately, I doubt if there are many who can provide this example because the challenge to even find someone who specialized in Aspergers was so difficult (easier in the U.K. and Australia then the U.S. though) before and now in the U.S. is near-impossible.

Since I am a believer that Aspergers should be treated by itself, I find it hard to see a benefit to the professional who is in favor of merging the two together. It was mentioned that neither counseling nor medications ever benefited the commenter personally. While I am always sorry to hear that, I am sadly not surprised. I think in regard to counseling, most are/were never given the opportunity to see a therapist that was truly knowledgeable about how to help them in the first place (if they do have or warrant an Asperger diagnosis).

As for the medication to treat Aspergers; useless. If it is not a hormonal or chemical imbalance causing the problems experienced but just a different processing ability within the brain that is hard-wired from before birth, those medications COULDN’T HELP.

SCREW YOU PHARMACEUTICAL COMPANIES!!!

Unless science figures out the neurological mapping and/or medications that can awaken parts of the brain that are not active, or connect specific identified pathways that are affected in Aspergers/Autism vs. NT cognitive processing, the medications out there being recommended are going to continue to be useless. I strongly believe this but unfortunately, I cannot back my words with scientifically proven facts since few find it worthy of investigating further. Medications are only beneficial after the unnecessary stress of needlessly trying to adapt to another way of thinking causes so much emotional turmoil to an Aspie adult that a medication may provide relief in numbing some of it. Even then, I am suspicious of how an antidepressant that targets chemicals within the brain is going to help an Aspie who may have a differing baseline than the majority-NT’s they were originally studied to help.

While I do believe the sensory issues sometimes common to both Aspergers and Autism can be effectively treated with similar behavior and environmental interventions, I do not think the social ones can be. Often people forget that these exact same sensory issues Aspies have (not those with Autism) are also something that NT’s experience very frequently, so I have not been convinced they are as linked to Aspergers or each other as the professionals are suggesting. I think it is more of the way the resulting stress of those sensory issues outwardly present themselves in those with Aspergers that keeps mistakenly highlighting them as symptoms of the disorder. Regardless, they should not be managed the same way by a mental health standpoint since the cognitive processing is likely to be so different.

Here I go on my tangent about the human brain from my basic understanding…

HOW IS INFORMATION PROCESSED IN THE BRAIN?

An individual’s brain contains approximately 100 billion nerve cells referred to as neurons. There are upwards of 10,000 synapses that connect one neuron to another (give or take a few thousand) and one neuron can be connected to 5,000-200,000 other neurons. Glia cells are the cells that support neurons and can clean up dead ones, or enhance the function of active ones. Neurotransmitters are the chemical mediums by which signals flow from one neuron to another.

HUH?

Imagine that I am holding a landline telephone in my hand (neuron) and I am attempting to share a one word response to someone’s question who lives across the globe (who is also holding a landline telephone in their hand), but it takes 10,000 different wires (synapses) to get my message to the other side of the world. These wires (synapses) can effectively send my message to the other person, and also enable upwards of 200,000 thousand other people holding a landline telephone in their hands to hear it the very moment I dial the number and an electrical current is transmitted through them (neurotransmitters). Enabling these wires to function are thick cables surrounding them that protect my transmitted message and keep it whole, as well as countless humans working to clear them of debris and rid faulty or broken cables along the way that could affect the pathway (glia). Now consider that if you cut even one of those wires, the word on the other end may be received garbled or it may be a different word with the same meaning to the one I spoke, or an entirely different and opposing word altogether… OR… it comes across in a different language!

Hopefully now you have my elementary understanding of how messages are sent and received in the brain. Let’s move on to the structure and function of the brain now.

THE INCREDIBLE AND POORLY UNDERSTOOD HUMAN BRAIN

Your brain is housed inside of a thick skull (laughing at myself) on top of your awesome body. It is comprised of the cerebrum, cerebellum, and brainstem. The cerebrum is the largest part with left and right hemispheres that control the opposing side (ie, if you jack up your left side the right side of your body will be adversely affected and vice versa). The cerebrum is the ultimate controller of functions like vision, hearing, speech, learning, sensations, reasoning, emotions, and fine motor movements.

The cerebrum is where the differences exist in Asperger’s syndrome and Autism!

The cerebellum (underneath the cerebrum) is our controller of posture and balance because it determines all coordinated muscle movements. The brainstem is our life (without the other two we could still technically be alive) as it controls breathing, heart rate, thermoregulation, digestion, swallowing, sleep/wake cycles, etc. You might now be seeing that the cerebellum and brainstem likely play a role in the the Autism-related “medical” issues, but they do not play a role in the Asperger ones (or lackthereof) at the same frequency despite the professionals who keep calling them symptoms of both disorders. The medical issues associated with Autism may have root causes in the cerebrum as well, but in Aspie and NT individuals, the likelihood of problems stemming from the cerebellum and brainstem are equal.

It is a *KARA-FACT* that the the cerebrum is 100% accountable for all things Aspie/NT!

As a nurse on an acute care multi-service unit that sees every imaginable patient from infant to elderly, I spend the majority of my time preoccupied with all-things related to the cerebellum and brainstem, often at the saddening exclusion of the cerebrum (despite having psychiatric patients and every patient warranting cerebrum-related attention). Because of this and the daily frustration I have at medical professionals bypassing the cerebrum in general (within the context of acute care), I haven’t any interest in discussing those parts of the brain in any of my blog posts.

I mentioned that the right controls the left and vice versa, but this is not entirely the case with all functions. As a general rule, the left hemisphere controls writing, speaking, comprehension, and even the ability to do math. The right is where artistic/musical ability is controlled, empathy and behavioral characteristics, personality and creativity.

CEREBRAL HEMISPHERES: GETTING DOWN TO THE NITTY GRITTY

There are four divided lobes that make up the two cerebral hemispheres, the frontal, temporal, parietal, and occipital (and these have further divisions I won’t get into). All of these lobes share varying complexities in how they work together and serve to promote or sometimes inhibit the others.

The frontal lobe mainly serves to control judgement, problem solving, intelligence, concentration, speech, body movements, and writing. It also controls behavior, emotions, and self-awareness. The Parietal lobe controls language interpretation, spatial and visual perception, memory, vision, hearing, and sensory functions like touch, temperature, and pain. The occipital lobe interprets vision in regard to movement, light, and color and the temporal lobe is the part responsible for understanding language, hearing, memory, sequencing and organization.

There is a term called Brain Lateralization whereby neural functions (cognitive processes) are more dominant on one side of the brain or the other. I am sure you have seen images of the brain in your lifetime that show two distinct chunks (the right and left hemisphere) that look like they could be split apart without much effort. If you’re having trouble visualizing it, here it is:

The two hemispheres are connected by a bundle of nerve fibers called the corpus callosum. If you took away this bundle, the brain would not be able to communicate between hemispheres, something that has been done in history to treat severe epilepsy. In these procedures, corpus callostomies were performed and very large portions of this bundle were removed entirely (these patients were called “split brain” patients). It was in the study of these split brain patients that science was able to definitively identify what hemispheres controlled what functions for the majority of the world, and further brain mapping research has made this unarguable science at this time.

Theory of Mind and Empathy have long been believed to stem from the frontal lobes (predominantly in the right frontal lobe) and this has been proven with repeated results throughout historical studies (http://brain.oxfordjournals.org/content/124/2/279). If you research the Mirror Neuron System you will come to find that there is a general agreement amongst the scientific community that Asperger’s syndrome shows a marked impairment within these areas of the brain (predominantly within the right frontal lobe). Men already have asymmetry in their brains (with greater use of their left hemisphere) when compared to females, so an Aspie male is genetically challenged in the areas of right-brain thinking from the very start and further compromised by their syndrome.

http://www.md-health.com/Lobes-Of-The-Brain.html

I already mentioned the neuroscientist Dr. Frank Duffy (See: WHAT DOES AUTISM SPECTRUM MEAN?) who was able to show that the brains of an individual with Aspergers and one with Autism were very different with the use of electroencephalogram comparisons. What I did not mention is that the children with Aspergers were shown to have much more neural connectivity in the area of their left hemisphere than the right when compared to both an Autistic and NT child. On MRI scanning there were very distinct differences in the brain of an Autistic individual and one with Asperger’s Syndrome as well.

The best imaging study I found in regard to a comparison between both Autism and Aspergers was published in the Journal of Psychiatry and Neuroscience in 2011. In this meta-analysis of MRI studies the distinct variations in affected parts of the brain are conclusively identified and they do NOTshow that the two are the same. While there are some lobes of the brain that show some minor overlap, they are few and far between when one looks at the differences.

For instance:

“Only for studies of Asperger syndrome did we note clusters of grey matter volume excess relative to controls to be primarily located in the left hemisphere, medial temporal lobe and inferior parietal lobule, with only 1 cluster of grey matter excess identified in the right hemisphere in the inferior parietal lobule.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201995/

Again, we are seeing/hearing that the “problem” associated with Asperger’s syndrome lies within the right hemisphere of the brain, whereas the Autistic brain shows differing parts of the right and left hemisphere with only a few similarities. What was the ultimate conclusion of this incredibly valid and peer-reviewed study?

“An ALE meta-analysis of grey matter differences in studies of Asperger syndrome or autism supports the argument against the disorder being considered solely a milder form of autism in neuroanatomic terms. Whereas grey matter differences in people with Asperger syndrome are indeed more sparse than those reported in studies of people with autism, the distribution and direction of differences in each category is distinctive. Asperger syndrome involves clusters of lower grey matter volume in the right hemisphere and clusters of greater grey matter volume in the left hemisphere. Autism leads to more extensive bilateral excess of grey matter. Both conditions share clusters of grey matter excess in the left ventral temporal lobe components of the extrastriate visual system. This summary of a rich VBM MRI data set has important implications for how we categorize people on the autism spectrum and cautions that mixing individuals with autism and Asperger syndrome may at times obscure important characteristics manifested in one or the other condition alone.”

(J Psychiatry Neurosci. 2011 Nov; 36(6): 412–421)

If the right hemisphere has a higher level of control over cognitive empathy, (and other areas shown to not be functioning “normally” in Asperger’s syndrome)… could it be that the very neural pathways required to process cognitive empathy are simply not there at all? I highly believe this to be the case, but that is as far as the scientific data can take it at this time so my theory (See: WHAT ABOUT EMPATHY?) will have to wait to be proven true.

I digress… Ok, so neuroscience appears to repeat the sentiments that the two are not the same. Yet here we are with them grouped together and no further funding put toward the isolation and study of Aspergers in and of itself.

According to Autism Society Org., the five major warning signs of Autism are:

Does not babble or coo by 12 months

Does not gesture (point, wave, grasp) by 12 months

Does not say single words by 16 months

Does not say two-word phrases on his or her own by 24 months

Has any loss of any language or social skill at any age

These are the medical conditions very frequently associated with Autism:

Gastrointestinal problems (Chronic constipation and diarrhea)

Low muscle tone

Seizures

Pain threshold abnormalities (Very high insensitivities or sensitivities to pain)

Well, we already know the major warning signs of Autism listed above do not apply to Asperger’s syndrome since impaired language is what everyone claims sets them apart. All of the listed medical conditions are not surprising when you look at the brain areas affected in a child or adult with Autism. These are not common to an Asperger child or adult any more than they are to someone considered Neurotypical. Yes, there are exceptions and some Aspies say they have similar medical problems, and there is no doubt they do. With them though, these could be related to medications commonly prescribed to an Asperger child/adult (ADHD medications alone can cause gastrointestinal and sleep disturbances) as can the antidepressants they often receive which would certainly make their medical symptom prevalence appear similar. They can also have zero connection at all to do with the neurological deficit causing aspergers and everything to do with genetic mutations and environmental exposure… just like every other medical condition out there for neurotypicals and aspies alike.

Aspie men and women have normal to above normal IQ’s. When you find an Aspie with a low IQ, it would make sense to consider High Functioning Autism over Aspergers (in my opinion). The problem with Aspergers and why it was lumped into Autism despite all diagnostics showing a distinct difference in the parts of the brain affected, once again, is because the professionals had inconsistencies in diagnosing it. It is not, and never has been because the two are the same. It truly is because those entrusted to identify them as separate could not get on board with the data and research and accomplish this! Due to the overlap in some of the symptoms in High Functioning Autism and Aspergers, everyone just threw their hands up and chose to deem them synonymous.

At this point in time, the only shared deficits or behaviors between Asperger’s syndrome and High Functioning Autism are the focus on special interests and impaired social communication (and even those can be differentiated when analyzed closer). Despite this fact, there is a constant claim that it is near-impossible to differentiate between the two. Of course there is an incredible difficulty doing this right now, they opted to stop moving forward in research to break them apart, and the confusion that exists now (which was already bad) is getting worse with the DSM-5 putting them in the same diagnostic category.

While no one can appear to agree on the cause of either disorder, it is generally accepted that Autism has a link to both genetic and nongenetic (environmental) roots. Even Nationally recognized groups that serve to educate the public about Autism agree with this.

“A number of nongenetic, or environmental, influence further increase a child’s risk. The clearest evidence of these environmental risk factors involves events before and during birth. They include advanced parental age at time of conception (both mom and dad), maternal illness during pregnancy, extreme prematurity and very low birth weight and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. Mothers exposed to high levels of pesticides and air pollution may also be at higher risk of having a child with ASD. It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk.”

There are no indications whatsoever that Asperger’s syndrome has anything but genetic foundations that develop when the individual’s brain is initially forming in utero. There are no links between those appropriately diagnosed with Aspergers and any of the common environmental associations observed in Autism.

I find it telling that the very people who have spent over 50 years working directly with and for Autistic individuals and raising awareness of Autism appear to want the two separated. Perhaps many people miss the statements within these national and global organizations that suggest this.

“We applaud the National Institute of Mental Health and its director Dr. Tom Insel, who has chosen not to place so much weight on the DSM-5 diagnosis categories. NIMH will not use DSM categories as the “gold standard” and will begin moving away from an exclusive focus on symptom-based categories.”

When a child or adult learns how to do anything, their brain is literally creating neural pathways (messages sent along synapses) to make a permanent connection to later retrieve this information. You are creating neural pathways as you read this silly blog post. The more a subject is repeated, the more synapses connect, creating something that can conceivably become automatic over time. This is exactly how cognitive-behavioral therapy works. Individuals are taught to look at something new, or in a new light, and then repetitious reinforcement, coupled with positive associations, develop behavioral modifications that can and often do become permanent (although not unalterable).

Neural pathways determine neurochemicals, or the strength of the information passed through synapses. Medications temporarily change the chemistry of the “strength” of the messages sent to and from neurons, but they cannot, I repeat CANNOT change the pathways themselves. What does this mean? It means if a pathway does not exist in the first place, or the neurons are not present on one end or the other (or both) to even transmit or receive these messages… there is no amount of medication that can create them. There is no way to medically help a person with Aspergers to develop cognitive empathy if the neurons and synapses associated with them are absent to begin with!

This is why chemical intervention and treatments are a cruel promise that will never deliver to the parents of children with Aspergers or the Aspies themselves.

There is this thing called neuroplasticity where the neural pathways in the brain are believed (and fairly well-proven) to remain changeable throughout a person’s lifetime. Cortical remapping has been proven in response to injury whereby the damaged part of the brain develops new pathways to re-establish functions thought lost with damage sustained to the brain. These brain changes can be in the neuron (messages) themselves (non-synaptic plasticity) or the synapses/pathways that transmit data to and from the neurons (synaptic plasticity).

This is important to me because there appears to be a very high likelihood that the deficits observed in Aspies have caused a more pronounced use of some other parts of their brain!

In other words, the same amount of neurons seem to exist to that of an NT brain, but the neurons disconnected from sending messages to the areas that handle emotional reciprocity, Theory of Mind (ToM), and empathy have instead lead to more connectivity in other areas of the brain. I also believe strongly that those with Asperger’s have affective empathy, but without the cognitive empathy to build that over time, the synapses are existent but the neurotransmitters have opted to be utilized elsewhere (giving the appearance of ZERO empathy). Perhaps these more active neurons (in places that do not control empathy) accounts for the increased sensitivity to light, sound, textures, etc.? Perhaps this accounts for the higher level of intelligence in logical processing or extreme focus on objects? This could be said for Autistic deficits as well, only their affected neural pathways are far vaster than that of an Aspie and likely account for the wide variation of deficits observed in more severe forms of the disability.

New trials are underway with some proven success in neuro-therapy to utilize brain stimulation techniques that aid in the recovery and treatment of stroke and schizophrenic patients. While I am struggling to find research on any trials of implementing this on Asperger or Autism affected individuals, it is something that certainly warrants attention. Exciting as this sounds, it seems that there would be a higher rate of success in working with autistic individuals who appear to have more deficits in parts of the brain that could target hemispheric transference. Since the male Asperger brain seems to be entirely lacking of synaptic connections within many right brain-dominant areas controlling empathy, there may not be a way to create synapses that simply do not exist.

If it is true that female Aspies have more synapses connecting their neurons within the parts of the brain that function to create affective empathy maybe neural stimulation could enable them to develop even greater empathetic intelligence over time.

If there is to be any real hope in regard to the treatment of Asperger men, it would be through the utilization of either cognitive behavioral therapy or neural stimulation. I highly doubt there exists an opportunity to ever create true cognitive empathy in an Aspie because I do not believe those neurons exist in those specific areas of the brain (PLEASE, SOMEONE DISCOUNT THIS!!!). I do still believe there are a billion other neurons in the Aspie brain whose synapses can be modified to enhance all of the other forms of communication that DO readily exist. I believe that honing in on these available neural synapses can better serve the Aspie within the context of interpersonal relationships.

GOING BACK TO THE ORIGINAL INSPIRATION BEHIND THIS POST

In regard to the question that Hilary posed about how psychiatry is going to help with the other deficits associated with ASD; I can only say that it would first require teasing out whether or not the child or person has Autism or Aspergers in the first place.

There is no way to specifically address the needs of any child or adult if there is no real understanding of what neurological deficits exist and require attention. Many of the other medical issues she mentioned in her children appear to indicate that they may have Autism, albeit, the “higher functioning” form of it. For them (if this is the case, and I am not claiming it is) the right therapists could work with “how” the medical problems affect or contribute to behavior/social ones. It would be nice to see neuroscience find the causative link between the mind and body, but we are a long way away from that. The answer for now would be for all disciplines of medicine to utilize interdisciplinary approaches and to work together to promote the best outcome for a person’s overall health.

So long as there exists blurred and confused understandings of the two “disorders” (making them indistinguishable on a therapeutic level) no parent is ever going to know if they are getting their child the right help that they deserve.

Until neuroscience can definitively prove the causation of either/both disorders, NO ONE should be boldly recommending that they be diagnosed or treated the same way!

“HIGH FUNCTIONING” IS A TERM DEVASTATING TO ASPERGER’S SYNDROME

It is important for me to challenge the overuse of the term “high functioning” as it relates to both Autism and Aspergers. I do believe that there exists High Functioning Autistic individuals who do not have the same debilitating deficits seen in some children with Autism, although I also believe calling anyone with such a challenging road “high functioning” to be inappropriate as it causes incredibly unjust perceptions by the outside world.

The term “high-functioning” is the most UNFAIR label to ever attach to anyone who has Asperger’s syndrome (and maybe parents of Autistic children will agree with this as well) because it gives the false idea that some are just less affected by their disorder than another (not true in Aspergers) and that they function “just fine” in the predominantly NT world.

NO ONE with Asperger’s syndrome is high-functioningin this NT world, in fact, the more “high-functioning” they appear, the greater likelihood they have adapted who they are to fit in and denied or suppressed the ability to actually be themselves. The most high functioning Aspies out there are likely suffering internally far more than those that isolate themselves and appear to be “lower-functioning” by society’s viewpoint.

I am not meaning to personally attack anyone’s use of that word, particularly parents, as it is appropriate for what many have been told to utilize in describing a child or adult who does not have the severely debilitating deficits (like extremely low IQ or impaired/absent speech) that can be seen in what was once called Classic Autism.

It is, however, the very use of the words “high-functioning” as it relates to an individual who should be diagnosed only as having Asperger’s syndrome that we now have a society who is becoming increasingly numb to the term autism in general. Just click on a news story about ASD (you can find a new one each and every day on one of the major media outlets online) and you will see people constantly posting about how individuals who are just “awkward” are using the term autism as an excuse of sorts. We are also seeing more parents who have Autistic children becoming resentful toward the Aspie children and adults deemed “high functioning” and expressing their upset over the use of the word autism when they feel their children (who are severely disabled) are now being overlooked.

CONCLUSIONS

My conclusions are as follows: Asperger’s syndrome and Autism (regardless of the functional ability) are NOTthe same thing. Neurology has proven that they are not the same thing and since they clearly have not been heard, there is an incredible need to continue funding the research of both (separately). Medicine, psychiatry, and other interdisciplinary approaches are essential in providing for the needs of individuals diagnosed with either Aspergers or Autism.

We need to stop going backwards in science where these two “disorders” are concerned and begin moving forward and finding the biological implications within the brains of those affected.

There may exist future therapies that can vastly improve the neural synapses that serve to define both Aspergers and Autism.

For now, cognitive behavioral therapy is the most effective means of creating improved interpersonal relationships and needs to be explored further.

I am so thankful for all of the responses and comments I have gotten about this blog, especially with how new it is. I genuinely respect and appreciate everyone’s thoughts and willingness to share personal glimpses into their own experiences.

I hope this post has cleared up why I believe that Aspergers and Autism are two distinctly different disorders and why I am an advocate for the separation and research into both of them in the future